A 47-year-old woman presents with fever (38.8°C), pruritic rash, and left flank pain 10 days after initiating omeprazole for reflux. Vital signs show BP 142/88 mmHg, HR 98/min, RR 18/min, SpO2 98% on room air. Serum creatinine increased from 0.9 to 2.1 mg/dL. Urinalysis demonstrates pyuria with 15% eosinophiluria. Complete blood count shows eosinophilia (8%). She denies dysuria. Which of the following is the most likely diagnosis?
- A)Prerenal azotemia
- B)Renal artery stenosis
- C)Postinfectious glomerulonephritis
- D)Acute tubular necrosis
- E)Acute interstitial nephritisGABARITO
Explicação
Acute interstitial nephritis is commonly triggered by drugs such as proton pump inhibitors, NSAIDs, penicillins, rifampin, and diuretics. Fever, rash, eosinophiluria, and rising creatinine after a new medication are classic clues. Ver explicação completa e trilha adaptativa →